Provider Demographics
NPI:1093192379
Name:KISS CAR SERVICE INC
Entity Type:Organization
Organization Name:KISS CAR SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GENERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-417-3940
Mailing Address - Street 1:2774 WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-3709
Mailing Address - Country:US
Mailing Address - Phone:917-417-3940
Mailing Address - Fax:
Practice Address - Street 1:2774 WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-9998
Practice Address - Country:US
Practice Address - Phone:917-417-3940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYB00647343800000X, 343900000X, 344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04059885Medicaid